Name of Drug Classification
Generic Name: Therapeutic classification:
Ceftriaxone Cephalosporins
Trade Name: Pharmacologic
Classification:
Forgram
Rocephin Ceftriaxone injection is
used to treat certain
Maximum Dose: infections caused by
bacteria such as gonorrhea
2g ,pelvic inflammatory
disease (, meningitis, and
Minimum Dose: infections of the lungs,
ears, skin, urinary tract,
250 mg blood, bones, joints, and
abdomen. Ceftriaxone
Availability: injection is also sometimes
given before certain types
injection, powder, for of surgery to prevent
solution infections that may develop
after the operation.
Ceftriaxone injection is in a
Pt’s dosage: class of medications called
cephalosporin antibiotics. It
works by killing bacteria.
Route : Antibiotics will not work for
colds, flu, or other viral
Intramuscular infections.
Intravenous
Pregnancy Category:
Pregnancy Category B
Mechanism of Action
Ceftriaxone is a bactericidal
agent that acts by inhibition of
bacterial cell wall synthesis.
Ceftriaxone has activity in the
presence of some beta-
lactamases, both
penicillinases and
cephalosporinases, of Gram-
negative and Gram-positive
bacteria.
Ceftriaxone binds to one or
more of the penicillin-binding
proteins (PBPs) which inhibits
the final transpeptidation step
of peptidoglycan synthesis in
bacterial cell wall, thus
inhibiting biosynthesis and
arresting cell wall assembly
resulting in bacterial cell
death.
Absorption: Peak plasma
concentrations after 2 hr (IM).
Distribution: Distributed
widely into body tissues and
fluids; CSF (therapeutic
concentrations). Crosses the
placenta and enters breast
milk; bile (high
concentrations). Protein-
binding: 85-95%.
Indication Contraindication Side Effects Nursing Responsibilities
General Indication: Hypersensitivity to BodyWhole: Before:
lidocaine (IM inj) Pruritus, fever, chills, pain,  Assess patient’s
Treatment of Hypersensitivity to induration at IM injection previous sensitivity
infections cephalosporins; site; phlebitis (IV site). reaction to penicillin or other
of the lower resp hyperbilirubinaemic cephalosporin
tract, neonates. Do not use GI: Diarrhea, abdominal  Assess patient for
acute bacterial calcium or calcium- cramps, signs and symptoms of
otitis containing solutions or pseudomembranous colitis,
infection before and
media, skin & skin products with or within biliary sludge.
during the treatment
structure infection, 48 hr of ceftriaxone
UTI, administration due to risk Urogenital:Genital pruritus;  Obtain C&S
uncomplicated of calcium-ceftriaxone moniliasis. before beginning drug
gonorrhea, pelvic precipitate formation. therapy to identify if
inflammatory Hematologic-Lymphatic correct treatment has
disease, been initiated.
bacterial Eosinophilia (6%);  Lab tests: Perform
septicemia, thrombocytosis (5%); culture and sensitivity
bone & joint leukopenia (2%). tests before initiation of
infections, therapy and
intra-abdominal Lab Tests periodically during
infections, Elevated ALT and AST (3%); therapy. Dosage may
meningitis elevated BUN (1%). be started pending test
results. Periodic
Pt’s indication: Local coagulation studies
Induration, tightness, or (PT and INR) should
- To reduce the warmth after IM be done.
development of administration (17%); During:
drug-resistant induration, pain, tenderness  Inspect injection sites for
bacteria and (1%). induration and inflammation.
maintain the Rotate sites. Note IV
effectiveness of Miscellaneous injection sites for signs of
Rocephin Edema, fatal ceftriaxone- phlebitis (redness, swelling,
(ceftriaxone) and calcium precipitates in lung pain)
other antibacterial and kidneys of neonates,
drugs, Rocephin oliguria (postmarketing).  Practice sterility throughout
procedure
Excretion: Via the urine (40-
65% as unchanged); via the
bile to the faeces (remainder
as unchanged and
microbiologically inactive
compounds);
Half-life 6-9 hr (elimination
half-life).
(ceftriaxone) Dermatologic
should be used Rash (2%); allergic
only to treat or dermatitis, erythema
prevent infections multiforme, exanthema, Lyell
that are proven or syndrome/TEN, Stevens-
strongly suspected Johnson syndrome, urticaria
to be caused by (postmarketing).
bacteria.
HEPATIC - elevations of
SGOT (3.1%) or SGPT
(3.3%). Less frequently
reported ( < 1%) were
elevations of alkaline
phosphatase and bilirubin.
RENAL - elevations of the
BUN (1.2%). Less frequently
reported ( < 1%) were
elevations of creatinine and
the presence of casts in the
urine.
 When giving IM, inject deeply
into large muscle (eg, upper
outer quadrant of gluteus
muscle, lateral thigh)
 Approach client properly
especially children
After:
 Monitor
hematologic,electrolytes,
renal and hepatic function.
 · Assess for
possible superinfection:
itching fever, malaise,
redness, diarhhea
 Monitor for manifestations of
hypersensitivity . Report their
appearance promptly and
discontinue drug.
 Watch for and report
signs: petechiae,
ecchymotic areas,
epistaxis, or any
unexplained bleeding.
Ceftriaxone appears to
alter vitamin K-producing
gut bacteria; therefore,
hypoprothrombinemic
bleeding may occur.
 Check for fever if
diarrhea occurs: Report
both promptly. The
incidence of antibiotic-
produced
pseudomembranous
colitis  is higher than with
most cephalosporins. Most
vulnerable patients:
chronically ill or debilitated
older adult patients
undergoing abdominal
surgery.